Catarrhal otitis media
The content of the article:
- Causes and risk factors
- Forms of the disease
- Disease stages
- Symptoms
- Diagnostics
- Treatment of catarrhal otitis media
- Potential consequences and complications
- Forecast
- Prevention
Catarrhal otitis media (secretory otitis media) is a catarrhal inflammatory process that occurs in the auditory tube and leads to a violation of its functions, which, in turn, and also becomes the cause of the accumulation of transudate in it.
Catarrhal otitis media develops against the background of inflammatory diseases of the nasal cavity and oropharynx. Most often seen in children from 4 to 10 years old. If left untreated, hearing loss may result.
Causes and risk factors
The infectious agents of catarrhal otitis media have not been precisely established. According to one of the theories, a viral infection leads to the development of the disease, according to the other - hypovirulent pathogens. It is possible that both of these statements are true. A certain role in the occurrence of catarrhal otitis media is played by the constitutional characteristics of the organism, namely the predisposition of the mucous membrane of the middle ear to hypersecretion, inflammation, and allergic edema.
In case of dysfunction of the auditory tube, the pressure in the tympanic cavity decreases, and the eardrum is pulled inward. This leads to an increase in blood circulation in the vessels of the mucous membrane and creates the prerequisites for sweating of serous exudate.
The main risk factors for the development of catarrhal otitis media in adults and children are:
- the presence of adenoid growths;
- frequent inflammatory diseases of the nasal cavity and paranasal sinuses;
- rhinosinusopathy of allergic genesis;
- irrational treatment of acute purulent otitis media;
- sudden changes in atmospheric pressure (going up the mountains by car, flying by plane).
Forms of the disease
Depending on the duration of the inflammatory process, catarrhal otitis media is divided into acute and chronic. Catarrhal otitis media in children often ends with a transition to a chronic form. This is due to the fact that children often cannot give a correct assessment of their condition, which is why treatment starts late.
In addition, the disease can be unilateral and bilateral.
Disease stages
Based on the features of morphological changes in the structures of the middle ear, there are three stages of catarrhal otitis media:
- Serous otitis media. In the tympanic cavity, a serous transudate accumulates, containing a small admixture of mucus.
- Sticky ear. The cells of the mucous membrane of the middle ear actively produce a mucous secretion, which, mixing with the products of cellular decay, becomes viscous and becomes sticky.
- Adhesive. The accumulated exudate is organized, the amount of mucus decreases. This creates conditions for the formation of an adhesive process, which leads to cicatricial obliteration of the tympanic cavity or adhesive (adhesive) otitis media.
Symptoms
With catarrhal otitis media, the general condition of patients practically does not suffer.
The main symptoms of the disease are:
- noise in the ear;
- a feeling of ear congestion;
- hearing loss with its variability when tilting the head;
- Autophony is an increased perception of one's own voice in one ear.
Pain in the affected ear with catarrhal otitis media is absent.
Diagnostics
Diagnostics is carried out by an otolaryngologist based on the patient's complaints of hearing impairment and otoscopy data.
Otoscopic signs of acute catarrhal otitis media are:
- retraction of the tympanic membrane;
- yellowish or yellowish-green color of the lower parts of the tympanic membrane (with influenza infection - cyanotic);
- eardrum vascular injection;
- the presence of fluid in the tympanic cavity.
In the chronic form of catarrhal otitis media, the tympanic membrane, due to its stretching, becomes so flabby and thin that during otoscopy it seems that it is completely absent. At the moment of blowing through the ear canal, it is again partially or completely displaced into the lumen of the external auditory canal. In some cases, calcareous plaques are clearly visible, visible through the epidermal and fibrous layers of the tympanic membrane, a sign of myringosclerosis. In the late stages of catarrhal otitis media, otoscopy shows adhesions and scars of the tympanic membrane, its soldering to the medial wall of the tympanic cavity.
Also, in the diagnosis of catarrhal otitis media, the following methods are used:
- impedance measurement - a flattened curve is detected;
- audiometry - an increase in the air conduction threshold is recorded;
- tuning forks - negative results of the experiments of Federici, Rinne are characteristic;
- X-ray of the bones of the skull - reduced pneumatization of the cells of the mastoid process;
- computed tomography of the temporal bones (performed in diagnostically difficult cases).
The method of endoscopic examination of the nasopharynx using a soft endoscope (fibroscopy) is widely used. It allows you to examine in detail the pharyngeal orifices of the auditory tubes, to identify the cause and nature of the obstruction of the auditory tube.
Treatment of catarrhal otitis media
In the treatment of catarrhal otitis media, conservative tactics are first resorted to, and only if it is ineffective, surgical intervention is performed.
Etiotropic therapy of catarrhal otitis media is based on eliminating the root cause of the disease (inflammation of the oropharynx, nasal cavity, paranasal sinuses). To anemize the nasal mucosa and improve the outflow of secretions from the tympanic cavity, vasoconstrictors in the form of nasal drops. In acute inflammation, catheterization of the auditory tubes is performed, followed by the introduction of antibiotics, glucocorticoids, proteolytic enzymes into them.
Source: lorklinika1.ru
After the acute inflammation subsides, the following procedures are performed:
- blowing out the auditory tubes;
- electrical stimulation of the auditory tubes;
- pneumatic tubomassage.
To stop the activity of inflammation, patients with catarrhal otitis media are prescribed non-steroidal anti-inflammatory drugs. Considering that high allergization plays a certain role in the pathogenesis of the development of the disease, the use of antihistamines is justified.
In the treatment of chronic catarrhal otitis media, physiotherapy methods are effective:
- electrophoresis with lidase, calcium chloride, diphenhydramine;
- helium-neon laser therapy through the pharyngeal opening of the auditory tube.
If therapy is ineffective, there are indications for surgical intervention (tympanopuncture, myringotomy, tympanotomy, shunting of the tympanic membrane by the classical method or according to Soldatov, transmastoidal drainage of the mastoid cave, the entrance to the cave and the tympanic cavity).
Potential consequences and complications
In the absence of the necessary treatment for catarrhal otitis media, adhesive and scarring processes in the middle ear lead to the development of persistent hearing loss.
Forecast
According to statistics, every second case of hearing loss is caused by catarrhal otitis media. This is due to the late appeal of patients to medical care. With the timely initiation of therapy, the prognosis for hearing preservation is favorable.
Prevention
Prevention of catarrhal otitis media includes the following measures:
- an increase in the general defenses of the body (hardening procedures, sports, balanced nutrition);
- timely detection and active treatment of inflammatory diseases of the oropharynx, nasal cavity and paranasal sinuses;
- annual flu vaccination;
- to give up smoking.
In addition, one should:
- avoid prolonged nasal congestion;
- do not allow water from open sources to enter the ear canal;
- carry out the correct cleaning of the ears from wax, avoiding trauma to the ear canal and eardrum;
- when the atmospheric pressure changes, for example, during takeoff or landing of an airplane, suck lollipops, constantly swallowing saliva (infants should be applied to the chest).
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
